Hormonal methods
Contraceptive implant under the skin
Implants require action only once every 3 and possibly up to 5 years.
A doctor inserts a small rod that contains a progestin under the skin of the inner arm.
Irregular or no menstrual periods during the first year
Headaches and weight gain
Restrictions for use are generally less than those for contraceptives that contain estrogen.
An incision is required to remove implants.
Progestin injection
An injection is given by a health care professional every 12 weeks.
Irregular bleeding (more or less frequent menstrual periods), which becomes less frequent with time
After 2 years, often no menstrual periods while injections are being used
Weight gain, headache, mood changes, and a temporary decrease in bone density
This method reduces the risk of uterine (endometrial) cancer, pelvic inflammatory disease, and iron deficiency anemia.
(IUD)
IUDs are inserted and removed by a doctor.
Irregular bleeding and/or no menstrual period
Rarely, perforation of the uterus
Occasionally, the IUD is expelled.
Oral contraceptives
Daily action is usually required.
With combination oral contraceptives (estrogen plus a progestin), a woman typically takes the contraceptive every day for 3 weeks, followed by an inactive pill every day for 1 week.
Progestin-only oral contraceptives are taken every day at the same time of day.
A visit to the doctor is required periodically to have the prescription renewed.
Combination oral contraceptives: Breakthrough bleeding* (usually only during the first few months of use)
Nausea, bloating, fluid retention, increased blood pressure, breast tenderness, headaches, and weight gain
Increased risk of blood clots
Progestin-only oral contraceptives: Irregular bleeding, no periods, headaches, and weight gain
Women who are 35 years or older and who smoke should not take oral contraceptives.
Certain conditions prohibit the use of oral contraceptives.
Women who take oral contraceptives are less likely to have menstrual cramps, premenstrual dysphoric disorder (a severe form of premenstrual syndrome), acne, and abnormal uterine bleeding. They are also less likely to develop osteoporosis and several types of cancer (such as endometrial cancer and ovarian cancer).
Skin patch
Women apply a new patch every week for 3 weeks, then remove it and leave it off for 1 week.
A visit to the doctor is required periodically to have the prescription renewed.
Similar to those of oral contraceptives
Skin irritation at the application site
Restrictions are similar to those of oral contraceptives.
Depending on when women start using the patch, they may need to use a backup method of birth control during the first week of use.
Vaginal ring
Women insert a ring once every 3 weeks, then remove it and not use it for 1 week. Or they may leave the ring in place for 4 or even 5 weeks, then remove it and replace it with a new one. A new ring is used each time.
A visit to the doctor is required periodically to have the prescription renewed.
Generally similar to those of oral contraceptives, except that irregular bleeding is typically less frequent with the ring
Restrictions are similar to those of oral contraceptives.
Depending on when women start using the ring, they may need to use a backup method of birth control during the first week of use.
Rings may be expelled. If they are expelled and then reinserted within 3 hours, no backup method of birth control is needed.
Barrier methods
Cervical cap
Women may insert a cervical cap 15 minutes to 40 hours before sexual intercourse. They must leave it in place for at least 6 hours after intercourse, but it should not stay in place for longer than 48 hours.
Allergic reactions and vaginal irritation
This method cannot be used during menstruation.
Condom
Men apply a condom immediately before every episode of sexual intercourse. The condom should be removed carefully to avoid spilling semen.
Condoms for women are inserted into the vagina, and the penis is carefully guided into the condom.
Condoms are discarded after one use.
Condoms are available over the counter.
Allergic reactions and skin irritation
Latex condoms are the only contraceptives that provide protection against all common sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection. Condoms made of a synthetic material such as polyurethane, polyisoprene, or silicon rubber provide some protection, but they are thinner and more likely to tear.
Condoms must be used correctly to be effective.
This method requires diligence and cooperation by the sex partner.
Contraceptive gel
The gel must be used within 1 hour before sexual intercourse.
Burning and itching in the genital area and vagina, yeast infections, and urinary tract infections
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Contraceptive sponge
The sponge can be inserted before sexual intercourse and is effective for 24 hours. It must be left in place for at least 6 hours after intercourse. It is discarded after one use.
Sponges are available over the counter.
Allergic reactions and vaginal dryness or irritation
Sponges may be difficult to remove. They must be removed after 30 hours.
Sponges are less effective than diaphragms.
Diaphragm with a spermicidal cream or gel (which kills sperm)
Women insert a diaphragm up to 2 hours before sexual intercourse. The diaphragm should be left in place for at least 6 to 8 hours and may be left in place for up to 24 hours. For most diaphragms, a doctor fits the diaphragm and checks the fit at least once a year and after childbirth. The SILCS diaphragm is an exception The SILCS diaphragm is a single-size contraceptive barrier device that does not require fitting by a doctor.
The spermicidal cream or gel used with a diaphragm may make insertion messy.
Allergic reactions, irritation in the genital area and vagina, and urinary tract infections
After initial insertion of the diaphragm, additional cream or gel should be inserted into the vagina before each episode of intercourse.
Spermicide alone
Must be placed in the vagina at least 10 to 30 minutes and no more than 1 hour before sexual intercourse each time
Burning, irritation, and rash in the genital area and vagina and urinary tract infections
Because efficacy is limited, spermicide is often used with other barrier methods.
Other methods
Copper IUD
Copper IUDs require action only once every 10 years.
IUDs are inserted and removed by a doctor.
Bleeding and/or pain
Rarely, perforation of the uterus
Occasionally, the IUD is expelled.
Fertility awareness (rhythm) methods
Women keep track of their fertile days by one or all of the following;
Using a calendar
Checking their cervical mucus almost every day
Checking their cervical mucus plus body temperature and other symptoms almost every day
None
This method requires diligence by women and abstinence from sexual intercourse several days a month. It is less effective for women with irregular menstrual cycles.
Withdrawal method
Men withdraw their penis from the vagina before ejaculation.
Self-control and precise timing are required.
None
This method is less effective than other methods because sperm may be released before ejaculation and because the man may not withdraw before ejaculation.
